Audio transcript (edited)

VICKI MANSFIELD: Hi, welcome to today’s webinar, everyone. I’m Vicki Mansfield. I’m a Practice Development Officer at Emerging Minds. First of all, I’d like to acknowledge the country that we all meet on today. I’d like to pay respects to Aboriginal and Torres Strait Islander peoples, their ancestors, elders past and present, and future, and to all the different First Nations across the country. I would like to acknowledge the importance of connection to land, culture, spirituality, ancestry, family, and community for the wellbeing of Aboriginal and Torres Strait Islander children and their families. And I pay my respects to the Aboriginal people of the Awabakal country, from which I’m meeting from today.

Before we start our chat today about our topic, I will just do some housekeeping. So, we’ll have a live Q&A at the end of today’s discussion, and you can go to put questions in via the Go to Webinar dashboard, which is in the top right hand, I think. The webinar’s also being recorded, and that will be available in the next two weeks on the AIFS webinar, under the Webinar banner on the website. We have quite a lot of related resources and readings for you all today, and that’s in the handout section on your go to webinar control panel. It’s a big topic, and we won’t be able to cover everything, so the resources can certainly help you have a deep dive into some of the topics a little bit further. We also have a short feedback survey at the end of the webinar and we really appreciate if you can complete the survey. That helps us gauge how the webinar was in meeting your needs today, but also helps us improve and consider future areas, etcetera.

Before we start talking about our village approach, I’d also invite the audience to recognise that there’s been many children, young people, and families from diverse communities with many lived experience who’ve come before us. This may include experiences of pain, trauma, including harmful systemic practices, and that this is something that requires our recognition and compassion, and we respect strengths and skills of people who’ve come before us and are committed to deeply listening and responding with integrity to their voices and expertise.

So, for today, our topic will be exploring how a village approach can support infant and toddler mental health. So, we know that in the first 2,000 day of life children are fully dependent on their relationships around them. So, when we’re thinking about infants and their mental health, we have to think about that they’re greatly influenced by their relationships with their carers, their communities, their culture, and the broader social context that they live in. So, they’re a little like babushka dolls. We have a little infant in the middle and then we have layers and layers of babushka dolls around them.

Many of us have heard the statement it takes a village to raise a child, which originated from Africa, and draws from a more collective view that caring for children is shared responsibility among many of us. In recent years, this concept of it takes a village was examined by Doctor Melinda Goodyear, a researcher with Emerging Minds. There’s two papers in the resources if people want to have a look at those. But Doctor Goodyear and her colleague’s project was titled, It Takes a Village, and it was based in Austria, and the project developed a co-designed model with parents who’d experienced mental illness and looked at promoting child focussed support networks. So, how to build that village.

The researchers evaluated how the model could increase access to prevention and early intervention for children, reduce the impacts of intergenerational vulnerability, and it also looked at how collaboration in the village can reduce the impacts of siloed practice, which can occur when we have a focus just on a medicalised or individualised perspective.

So, thinking about and reflecting on that research, our topic today, and our webinar today really explores that village approach which may be occurring right here already, and our panellists have a great deal of experience and knowledge about the village approach. So, our panellist’s bios can be found in the go to webinar dashboard, but it’s my pleasure to introduce Viv Kissane, the CEO of Peach Tree Perinatal Wellness. Welcome, Viv. Nice to have you here with us today. And then I’d also like to introduce Amy Parker, who’s a mum of three and an advocate for peer based mental health support. Amy tells me that her official title within her village is Peachy Mumma, which is such a warm embracing title and tells me lots straight away about her village as well. So, welcome, Amy.

AMY PARKER: Good morning. Good afternoon, sorry.

VICKI MANSFIELD: Unfortunately, Lyndsay Healey who is our Director of Gowrie South Australia Child Care isn’t able to be with us today. In the resources section of the webinar, there is a link to a podcast with an interview with Lyndsay and our Emerging Minds family’s team, and that really is a great interview which captures her perspectives on infant mental health. Lyndsay also features in our practice strategies for formulation for infant and toddlers. So, yeah, there’s some resources there if you want to follow those up. So, to jump into our exploration of the village approach. I’m wondering, Viv, if you can share how Peach Tree has a village building approach and how that promotes infant and family mental health.

VIV KASSANE: Yeah, absolutely. So, thank you for the invitation for us to join today. We are coming from Meanjin in Brisbane, which is the lands of the Jagera and Turrbal people. So, I quite often use the term village building approach when I talk about Peach Tree and the way that we do things. We also predominantly use a lived experience or a peer approach of a service delivery model as well. Basically, to Peach Tree, what a village building approach means is that although we are funded as a perinatal mental health service, what we actually do is we take quite a holistic approach to how we deliver those mental health services. 

So, in addition to running peer support groups for pregnant women, for mothers, for fathers and for carers, we also run a lot of other things as well. We run parenting programs mental health literacy workshops and what we do is we actually wrap it all around with what we call our social inclusion work. So, we also run things like mums and bubs yoga and baby song time and crafternoons, for example. We run these out of our parent wellbeing centres. We have three of them located throughout the Brisbane region. These hubs are basically places for us to centralise really helpful services and to build community for the people who are going through this pregnancy post-natal and early parenthood time of life. Through our parent wellbeing centres we try and reduce the barriers for people to find and access help and support that they need to help them in their pregnancy and early parenting experiences.

So, we all know how much that loneliness and social isolation can really impact our emotional and social and mental health and wellbeing. So, we really make a conscious effort at Peach Tree to try and create a space where people can feel welcome, feel like they belong and that they can find connection with other like-minded people who are going through the same or similar experiences in this time of life. We do use a lived experience workforce, so a peer workforce, and what we find is this workforce is really effective at de-stigmatising mental health challenges at this time of life, and role-modelling help-seeking behaviour, and providing hope and optimism as well around the challenges that can be quite normal around this time of life.

So, yeah, working with parents to create a place to belong. Often – and this is a broad generalisation, but infants can be unseen in maternal services. So, really, it’s essential in our perinatal mental health service to make sure that we really remain vigilant in being able to see the baby, because infant mental health is really focussed on those early relationships that they have with their parents. So, by wrapping a village approach around parents, we’re also wrapping a village around infants and children, and that’s really, really important.

VICKI MANSFIELD: Viv, it’s quite a comprehensive service, Peach Tree, in the model that you provide. As you said, it is easy for infants to be lost and particularly when we might have an adult individualised kind of framework and so, it sounds like Peach Tree kind of keeps circling back to what does this mean for infants as well.

VIV KASSANE: Yeah, absolutely. It’s always been conscious of actively reminding ourselves that the infant is included in this work, and is a little person all in their own rights, and actively reminding ourselves to always keep baby in mind.

VICKI MANSFIELD: Yeah. Thanks, Viv. Amy, how important has that village been for you and your children in the early years of parenting?

AMY PARKER: Oh, that’s such a good question. I have so much to speak to my experience of raising my children in a village. I originally come from the UK and when I first found out I was pregnant I knew that with pre-existing mental health challenges and having no direct family members around me to support me, that it was going to be really challenging. I first engaged with Peach Tree and their services when I found myself, after a few weeks, stuck between four walls with a brand new baby. I felt really lost, in over my head, and when I first went to Peach Tree I discovered the actual practical concept of what a village was. I went into a room of mothers from all walks of life, sat in a room together, all feeling similar. It was really nitty-gritty negative postpartum feelings and struggles. 

There was a natural flow about wanting to support each other in that space, whole space for each other’s voices, and just come together and support each other. I think there was a natural instinct within us, a maternal instinct that we just wanted to help and learn from each other about how to raise our children, allude the mum guilt. I guess being with Peach Tree for several years now, I guess I’d like to share a couple of experiences that really encapsulate what a village has meant to me and my family. Is that all right?

VICKI MANSFIELD: Yes. Yeah, that’d be awesome. I think it’s great to hear the practical ways and the emotional support. So, yeah, any examples would be great to hear, Amy.

AMY PARKER: Okay. So, I remember after I had my second child, my son, one of the Peachy mums set up a meal train online which is a service that you can, as a person, volunteer your services to cook meals for somebody, a recipient of that meal train. So, one of the mums set that up, posted it in Peach Tree social media group, and for the first six weeks of my postpartum with my second child I had complete strangers coming to feed me and my family, leaving meals at the door for me. That was just so kind and the selflessness about it that we were just all in it together and all there for each other, even if we didn’t know each other. 

Another example I’ll share is a dear Peachy mum friend of mine went through some really rough stuff with an infant loss. So, I’ll try not to trigger anybody with this. But when she had that infancy loss, everybody rallied together to set up a WhatsApp group called the Blank Village, where we all coordinated support for that mother and what that looked like. So, I personally volunteered to cook meals and bring them around to fill up their freezer so that cooking wasn’t a worry, and go through that period of grief and all those huge emotions. Another person helped set up flowers for a funeral. Another person offered childcare. It was just a way that we came together to coordinate around that mumma, and a really rough time. So, that to me, encapsulates exactly what a village is, is we’re just all in it together and all there for each other. 

VICKI MANSFIELD: Yeah. It really strikes me, Amy about the mutuality and this reciprocity of that. So, in terms of what you’re receiving, but also in what you’re giving back. Viv, you mentioned before that it’s a place that give hope because I think that period of adjustment and when there’s such challenges at times in that period of adjustment, for all of us it’s a huge period of adjustment. But loss or isolation can add vulnerability to that as well. Viv, do you want to share your perspectives on that reciprocity and mutuality that you think is a part of the village or that you’ve created what safety creates that? 

VIV KASSANE: Yeah. So, thank you for sharing that, Amy. I love hearing that because that’s kind of what we do at Peach Tree. So, obviously those mothers have gone off and formed that village building stuff together, and all Peach Tree did was facilitate the connection and provide I guess the platform and the opportunity for that connection to happen. So, it really is heart-warming to hear those stories. Look, I think a big part of peer work, I suppose, peer practice, is mutuality and reciprocity and I think there are really lovely ways for sharing respect, sharing stories. The idea that we’re both giving and receiving support is really validating as well, and self-empowering to feel like hey, I’m also helping somebody here, and there’s value in that, there’s self-value in that for me.

Mutuality as a peer worker is just acknowledging as well that power balances do exist in this relationship and so, acknowledging them and trying to build trusting and supportive relationships in a really fair and equitable way, and really acknowledging that by allowing the space for mutuality, by allowing curiosity, by allowing vulnerability, by allowing respect that we’re all getting something out of this.

VICKI MANSFIELD: Yeah. Thanks, Viv. Amy, thank you for sharing, because what I think it really highlights is that your village is holding each other. And certainly in my work experience in social work, working in perinatal and infant mental health, theoretically around infant mental health we’re aiming to hold both parent and child and hold the needs of both. I think what you both just described is beautiful examples of villages holding both parent and child, and that is so powerful for nurturing infant’s mental health I think, nurturing children’s mental health, whilst you’re also holding the parent’s wellbeing and needs in mind as well. 

Viv, I was wondering if you could share a little bit – there are barriers I think sometimes, and challenges for – you mentioned stigma and you mentioned – and certainly in my experience there can be a sense of shame about reaching out, there’s a lot of pressure on parents now to think that we need to have it all together, and there’s a lot of pressures on what social expectations there are about how we parent. So, why do you think that connection and wraparound of social inclusion’s so important in this period particularly, do you think it’s particularly important?

VIV KASSANE: Yeah, absolutely. You’re right. I think we as a society have progressed a long way in the last decade in terms of de-stigmatising mental health and normalising reaching out when you need it. But unfortunately, I still do think stigma is still over-prevalent in the perinatal and infant stage, and probably more so from self-stigma perception specifically. What we find is perinatal mental health needs are along a continuum of care, which means that we really see parents who may have had previous mental health experiences and may be exiting out of inpatient care, quite familiar and used to mental health language and treatment, that type of thing, and feel more comfortable using that lens.

But also, what we find is that quite often this is the first time that a mother might be experiencing mental health problems in this perinatal or the post-partum period. She might just feel like she’s at home crying all the time but doesn’t know why. It’s also very easily to externalise the reasoning for that. It’s not here, it’s just my baby won’t sleep, or breastfeeding isn’t going well, for example. So, to picture mental health service at that cohort of people you’re really missing the mark. So, this is why I think the village approach and in particular, having options for the broader community to join in, in social activities is really important.

So, mum might not come to our mental health peer support group, but she might come to a baby song time. What happens is it comes to the baby song time where she has a really lovely time with her baby, she meets the peer workers here, she gets a feel of the place, she looks at the brochures of our services, she meets other people, builds that safety connection trust, and more often than not then she’ll go home and she’ll refer herself into our mental health support services. So, I think it’s really important that we recognise that continuum and that. People are all different and being flexible in our approach to make sure that everybody is getting needs met.

VICKI MANSFIELD: Yeah. I love that flexibility because certainly, I think as you said, it’s a continuum and that it’s a huge period of change and adjustment for all families. Like, we get quite a glossy view. I think you were mentioning this, Amy, before, we get a glossy view of having a baby, starting a family. But actually, it’s a time of really high vulnerability and can be really challenging. Also, that connection with our baby is something that takes time. In my work with perinatal infant mental health, certainly that was a common conversation that this is a connection that takes time and you get to know each other over time, rather than just it’s something instantaneous. Viv, I’ll just ask as well because we’re talking about mums, Peach Tree also provides services for dads?

VIV KASSANE: Yes. So, it’s been a little bit harder to engage fathers, so it’s still not as far progressed as we would like. But we have previously run dad support groups through COVID. That kind of fell down a little bit. So, we’ve just been spending some time trying to rebuild that, and that’s definitely one of the priority areas that we’ll be focussing on. Because it’s really important. A lot of fathers are also overlooked and missed in this period. And because having a baby is a major life event, while women or birthing people have the physical experiences along with that, it’s a major life event. So, fathers can struggle as well as change of identity, financial responsibilities, loads on contributing vulnerabilities for them at this time as well. They need a village just as much as everybody else.

AMY PARKER: I just wanted to speak to that about the father side of things. So, I feel that there’s an even higher stigma with mums needing to be okay. But there’s also a stigma around the dads showing any sort of emotion at all. I think that makes it hard for them to break through that barrier of accepting their emotions for what they are, and be speaking to that, rather than just pushing it down and carrying on the stigma that men are emotionless shells. So, we know they’re absolutely not.

VICKI MANSFIELD: Yeah, I think you’re right, Amy, in there’s a lot of social expectations about how you might be as a man or a dad as well. Yeah, I think that’s important for us as service providers to be conscious about. Amy, in terms of your experience with the group work or the different avenues Viv mentioned of coming in to a service, can you tell us a bit about how the group work or the groups have supported you in your connection with your children?

AMY PARKER: Okay. Yes. I’ll just speak to what Viv said first about facilitating a space, and that’s really important to what I’m about to speak to about the programs that I have participated in. The most important thing about that space that was facilitated is that it was non-judgemental, which is really important. I feel that we go in thinking that we are going to be judged on our parenting, judged on how we feel about it, those really nitty-gritty feelings. So, Peach Tree facilitated a really safe non-judgemental space for us to be able to make those connections, which I feel like is just such an important aspect of what Peach Tree is about.

But going back to my experiences about all the things that I’ve done, I call them my live toolkit skills. I participated in Circle of Security, Sunshine Parenting, Peer Zone, which I’ll highlight that in a sense that it helped us be able to work on our language and how we speak to each other in our village, how we communicate, how we listen, how we validate. Which those skills also roll down to how we take care of our children, how we address their big emotions in their tiny body. There’s so much more to it. I think outside the basics of keeping the child alive and healthy, shelter, food, water, there’s a huge responsibility for their emotion and health and wellbeing, which I believe I picked up the skills in the workshop Circle of Security, especially just about making sure I’m building a secure attachment and my kids feel safe with those big emotions around me. 

VICKI MANSFIELD: Amy, it sounds like it was powerful for you to experience that alongside other people in the village. So, we might be able to do that individualised in counselling or online, but having that experience together with your village, sounds like that was quite normalising and empowering in lots of ways.

AMY PARKER: Oh, absolutely. Just having a share of what we’ve learnt in those workshops to new mums that come into our village and just having tools to give them to help them learn how to get onboard and support their kid’s emotional regulation and just how to deal with those negative behaviours there’s such a thing. Negative behaviours is not – I hate the word negative. It’s the way that I’ve been taught through the workshops is that it’s every behaviour is an expression. It’s something that’s put out there when they don’t have the words, which they don’t from the first few years of life.

VICKI MANSFIELD: No. And it’s a real skill to be able to kind of put to a wondering a guess, as Viv said before, that curiosity about what they’re telling us with their behaviour, that you said about their big emotions and absolutely, there’s so many big emotions for infants and toddlers. So, I think that’s a great reflection, Amy, to see that, having that support of being able to build up our toolkit of oh, I wonder what it is that’s underneath that. What’s the needs that they might be expressing in the 20th time for that day because they do it a lot too. So, it’s a flustering time for parents.

AMY PARKER: Yeah, it certainly is. We automatically have to become the co-regulator of everything that’s going on in their world. Like you said, every behaviour is them communicating a need that we have to figure out how to meet, and the skills that are learnt in those workshops were about how to meet those, how to recognise and understand what they are trying to communicate to you. Even with those skills, it’s still really challenging to figure out – young children are a puzzle! But yeah, just having those skills really helped me be able to offer that emotional and mental health support for my children.

VICKI MANSFIELD: Awesome. I think offering it for your children, and as you said, supporting each other and developing those supports within ourselves to manage for our own wellbeing as well is so powerful. One of the things that stands out for me as well, was an area that we’re going to talk with Lyndsay about, so I just want to kind of link that in, even though we’re not able to draw on her wisdom. But I think in terms of the village, there’s many parts of the village. So, Peach Tree has certainly developed a strong village around it, but there’s also – Viv, I think you guys do some links with other sorts of services as well, like you have a service where people might be held whilst before they link into like, counselling or something like that, is that correct?

VIV KASSANE: Yeah, absolutely. So, again, this hub kind of model, we might not have the service here, but we’ve got the information and can help make that connection to that other service might be really helpful.

VICKI MANSFIELD: Yeah. One of the other main services that I think there’s a really important part of infants and toddlers village, and certainly their family’s village, is I think childhood, child care centres and educators. Certainly, looking at the Australian Institute of Health and Welfare report for 2022 we have approximately 30% of infants under the age of one attend child care. 62% of one year old’s attend child care and 72% of two year old’s are enrolled in child care. So, that’s a significant number and a significant support. So, that child care is really a place that’s central to the village I think. So, we often might think of the village as informal supports, but I think it’s helpful for us also to consider the collaboration of formal supports that might be like, services. 

In my experience, certainly when I’m working with families I did visits to child care so I could get educator’s perspectives. They’re often really skilled at observing children and attuning to children’s needs. So, it’s often helpful from a kind of whole picture of children’s mental health to get the perspective of educators. But I also think one of the things that always stood out for me was that it’s really important for educators and families to have a really strong relationship and communication and partnership together, because I think otherwise that can feel quite vulnerable if you’re a parent and you’re getting feedback about your child. That can feel quite vulnerable. But also, in terms of child cares valuing the strength and insights and knowledge that families bring, and also, the context that they are in.

Amy, I’m wondering how important is a good relationship with educators and child care providers, from your perspective, and what helps a parent feel supported?

AMY PARKER: So, my children, now only child, I have two in school now. But over my journey I’ve had two of my children in childcare part time, which has enabled me to work on my own personal mental health battles. Because being a full-time parent you don’t always have the capacity to do that. You’re really called on the needs of the child most of the time. As a parent, as a mother, I have struggled to have my needs met. By having the kids in childcare, it’s on the premise that when they’re there, they’re going to be safe, they’re going to be supported and their emotional needs are meet and there's some level of what structure you have as a parent, modelled within the time that they’re not with you, in the centre.

So, I've kept a really good open stream of communication with our educators, they really do fill me in on the day and challenges my children faced where their emotional needs are needing to be met at the end of the day. So, I'm really grateful for that and I really inspire all parents to push for that open stream of communication with the childcare centres and their educators. I think it’s really important. They spend just as much time with them as they do with us. So, I feel like that should be on the priority list to make sure that there's open stream of communication.

VICKI MANSFIELD: Yeah. An open stream of communication, and I know Lindsay has a very strong stance around that educators also have a really vital role in reaching out and being attuned to families experiences and being able to tune in to parents and check in with parents, rather than waiting until it might be snowballed to a more crisis point. So, yeah, I know she was talking very clearly about educators having such a vital role in being able to reach out and form connections and supports with parents and their attunement. So, I think it’s great from a clinical perspective or from a practitioner perspective to be always thinking about those early childhood educators, child, and family nurses, speechies, OTs, all of those can form part of our village and having those relationships is really again about centring the child’s need in there as well.

Thinking about some of the barriers for families, I was just wondering, Viv, if there was a particular mindset that you would recommend for a practitioner in terms of when they might be assessing and engaging with families, that would help them understand the barriers or the vulnerabilities? What might help practitioners, some kind of practical strategies or what perspectives are important?

VIV KASSANE: Look, I think there's a clear standout, and I think it doesn’t matter if you’re a lived experience practitioner, or you’re working within a clinical or medical model, or whether you’re an educator or what I think the common thread between all of those disciplines has to be trauma informed care. I think if we’re all working from that perspective then we’re going a long way towards creating an environment that's going to be really responsive to human beings as being human beings. So, at Peach Tree, we use trauma informed principles basically as our guiding principles for our organisation and we use that as I guess, pillars or guideposts in terms of any decisions that we’re making in terms of operationally within the organisation, but also about how we deliver services.

So, if we think about those principles of safety, trustworthiness, choice, collaboration, and empowerment and how we think about that, and how we apply that. So, we do that at Peach Tree right from the moment that someone walks through the front door. How they’re greeted, how they’re welcomed, what the physical space looks and feels like. For some people walking through that door, that was a really hard thing to do. The way we greet, and the way that we want people to feel welcomed and we want them to say, “Hey, we’re really glad that you walked through that door.” So, first and foremost that.

In terms of how we practice, it’s active listening, so being really present when we’re talking with parents. Not being distracted by phones or you can have our attention, and not trying to fix, we’re listening to learn and understand. We’re not listening to try fix you. And really, we don’t prescribe to labelling here as well. So, you don’t need a diagnosis, or you don’t need a mental health care plan or anything like that to access your service. If you’re someone who’s identifying that you need help, then we’re happy to help you. So, it’s about reducing that barrier.

I think other things about how we apply trauma-informed care is using strength-based approaches. Unfortunately, like in perinatal and infant period, there is a lot of deficit-based language around. So, ‘failure to thrive’, that type of thing. So, we make a really conscious choice to making sure that we’re using positive language and also reframing experiences as well, so that they’re not looking at the failure or the deficit of the person. We use circle of security a lot at Peach Tree. Not only do we deliver it as a small workshop to our community, but we also use it as a shared language across our staff. We use a lot of circle language in the way that we communicate with each other as a team, and they way that we communicate with our community as well. So, we’ve all got a shared understanding.

Luckily for us, lived experience work really naturally aligns with trauma informed work as well. So, key peer principles such a being person-led, self-determination, so recognising that people are the experts of their own life and are best placed to make the choices and the decisions for themselves and their infants and their families, whether we agree with them or not. In practice, that can be a really delicate line to balance in terms of the dignity of risk, verses duty of care. So, there's complexity, and really being able to sit in that discomfort of people owning their choices.

VICKI MANSFIELD: I think, Viv, that really resonates with me in that sense of the dignity of risk and managing risk and people self-determination. Having worked with women and children around family domestic violence, that's something that – there was significant isolation and there was a need for a village, but I also needed to respect the pace of mum’s choices around being about to reach out or connect with family after they’ve left violence. So, there’s again, I think as you said, that person-led going at the pace of the person and respecting self-determination and at times having ethical challenges around that is something that we definitely need to reflect on.

That's certainly an important skill, I think, in terms of infant mental health, it’s that always coming back and reflecting on what does this mean for an infant. But also weighing up all of those things and holding them, getting support to hold them, I think, so that you have a village. As a practitioner, I would say you need a village around you as a practitioner to support people in their village as well. Because it’s not a one person to do it.

VIV KASSANE: Absolutely. We come across really challenging, you know, people who are facing really challenging circumstances. I think we’re naturally drawn to this work as well, because we’re empathetic and we want to help. I think it’s really important in that respect that as an organisation that we’ve got really robust organisational policies and procedures at a governance level, but that feeds down into staff as well, so that they’ve got a really comprehensive understanding when they come across these circumstances that they know how they’re expected to respond in those situations. So, training and ongoing supervision for workforce is absolutely essential as well. That community of practice and debriefing and all of that is part of that, the practitioner village.

VICKI MANSFIELD: The practitioner village, absolutely, and that helps in safety for the village in general and safety for the wellbeing of everyone. I'm conscious that we’re about to move probably to our Q&A time. Amy, can I ask you and then I’ll ask you Viv, we spoke about quite a few areas, about the village approach and I really appreciate, both of you sharing your experiences and insights. What would be your take home message for the audience before we move to our Q&A? Amy or Viv, whoever would like to go first.

AMY PARKER: I'm happy to do it. I just wanted to say, this all parents, you don’t have to do it alone, there are supports out there. Non-clinical textbook support in the form of peer led constructs. I think there needs to be a de-stigmatisation of all of those nitty-gritty experiences of parenthood. I guess I just want to say there's a village for everybody. We’re all individuals and that looks different for everybody. But there is a village out there for everyone.

VICKI MANSFIELD: Lovely. I think such a powerful message. Thanks so much, Amy, it’s been great to hear your experiences. Viv?

VIV KASSANE: Yes. So, I think my key messages to everybody is just to stay curious. We’re constantly learning. Parents are also constantly learning, so we need to be patient, we need to be kind. Like Amy mentioned early on, we need to drop the judgement. Leave that at the door. No one’s going to come back to your service if they walk away feeling like they’ve been judged. I think as services, practitioners, we need to embrace the role as being a connector and building support. So, even if that's not what your service or business does, it’s maybe just that responsibility of knowing what’s out in your local community. At Peach Tree we keep a little database and spreadsheet so that when we hear about things like library groups or swimming clubs or those types of things, and we’ve got notice boards and things like that about putting that information up. So, yeah.

VICKI MANSFIELD: Yeah, being connector. I think that's certainly, it’s key for infant mental health, connections. So, it kind of again, is those Babushka Dolls, out and out, full of connections. So, we had a lot of questions come, some pre-registration questions and also some come through our webinar chat. We’ll also record at the end of the session, we’ll record some additional questions, which will be in the recorded versions. So, when you get the link, you can access that as well. One of the questions for Viv was, are there legal services included in the wrap around services at Peach Tree?

VIV KASSANE: No. Not at Peach Tree, specifically. We predominantly just provide services around social, emotional, and mental health and wellbeing. But legal services would definitely be one of those referral pathways that we make sure that we have in place. Legal services is usually quite expensive and a barrier for people as well. Women’s Legal Centre and places like that are all in our referral database.

VICKI MANSFIELD: These two questions are probably linked. It was how do we promote the importance of families accessing wider community village? And was there any tips for practitioners on how to start to help people to build their village? I think we spoke earlier about isolation and certainly, as a practitioner my sense is that when I'm undertaking an assessment, I always ask people who is important in their life. So, that might start with families and friends, and then looking at if there's a broader kind of – do you attend groups of what’s the barriers to what might be linking out. Amy or Viv, do you have any tips, or how do you promote that important of connecting in?

AMY PARKER: When we become a parent, we automatically become our child’s advocate. Whether we’re aware of it or not. Our children have a very little voice in this world, and it’s really important for us to speak for them. Even though they can’t really advocate for themselves, they can communicate their needs to us. It’s really important for us to pay attention to those cues that they put our there, and create a world – spaces for them to feel safe and feel heard. That’s why the village is so important. It creates that world and that space to which is kind of custom built by our children and their individual needs, that they have to be met. We create what they need around them. Generationally, we were told children were to be seen and not heard. It’s taken a lot of work to get to a place where children are being seen and heard, even when they don’t have a voice.

VICKI MANSFIELD: Amy, that's a really – such a lovely, infant-focussed perspective. I think that is often a starting place for a practitioner. I would often call that – and in our courses, we have some tips around this, is speaking to or for the infant. So, as you say, they’re expressing needs, or we’re being an advocate for them. So, as a practitioner, sometimes it’s helpful to be inner curious as you said, but Viv, it’s always from a place of curiosity and strength, rather than of judgement, definitely. But being curious about what it might mean for this little person if you we to maybe step out of your comfort zone to do this or to do that.

Our children can be great motivators, and exploring for what it might mean for them, can support people in that process of taking that step when it may be really vulnerable to reach out or connect with someone. It’s not always easy for us to form those relationships. But having an infant focus is really often a great – parents are so often wanting to do the best by their children. Viv, did you have any other tips, or Amy? Sorry, I cut you off there.

AMY PARKER: No, you haven’t at all. Viv, you go ahead.

VICKI MANSFIELD: Viv, any tips?

VIV KASSANE: I think you've kind of covered it. Because I was going to say it’s about, as a practitioner, it’s active listening and curious questioning. Again, someone’s walking through the door, help seeking, it’s not here to go, “Okay, well, you need this, and you need, and you need this.” It’s active listening, listening to what people are experiencing, what they’re going through, curious questioning and then having the information and resources available to give them.

VICKI MANSFIELD: Certainly, again from my perspective it’s that, often when we’re talking about connecting with a village, we’re talking about or relationship skills and that's not always something that is easy for each of us humans. So, we’ll all have different relational styles and it’s really important I think to have a self-awareness of our own assumptions and bias, but also bring forth what it means for that person to be relating.

I'm getting a question hot off the press. So, if we can’t get to it now, we may be able to get to it in the recording. How can practitioners encourage other practitioners and professionals to recognise the importance of social connection as opposed to focussing on medical models and diagnoses. It’s a big question, I’ll name that first up. We’ve not got a lot of time, so it may be one that we address afterwards. Is there any first response that you’d like to make, Viv, or shall we put that in the recording afterwards.

VIV KASSANE: Look, it is a big one and I’m happy to speak more in depth about it. But just very briefly, I mean, it’s a hard job. I think currently, parenthood in general is very over medicalised and over pathologized. I think it’s just going to take time and commitment that we just have to keep advocating for this approach. Hopefully, over time, there will be that shift in culture about the way that we think about parenthood.

VICKI MANSFIELD: From working within health systems and mental health systems, I know that, it can be very task focused and medicalised in terms of – so, often I think it is really important to come back to what does this mean for the infant, and over time we come back to what does this mean for the infant that in some ways means that we start to think about relationship and what does that mean for a parent if we’re only looking at the medicalised symptoms and function of an adult. Then we’re not thinking about what does this mean for their parenting, what does this mean for their day-to-day life.

Certainly, our courses, practice strategies for assessment and formulation both give quite a few strategies around how to discover the infant’s experience, how to have some more in-depth conversation with practitioners and with your multidisciplinary team about what that means for the infant in terms of not just a medicalised perspective, but what it means socially for that family as well. So, taking a bigger picture. I think it is a chipping away at the system as well. Amy, would you like to offer any comment about having a bigger picture than just being a label or being medicalised?

AMY PARKER: I’ll just speak about practitioners and clinicians. Obviously, I've said Peach Tree was the first peer led construct. Initially, it was really intimidating because I had been through so many services, practitioners, clinicians, that do go textbook clinical, medical, support. Often for those appointments I would turn up with my infant and you get the feeling and the vibe, I guess, that they’re not supposed to be there. Even though they are part of that support, needing the clinician, need that practitioner involved with them. But it feels like they shouldn’t even be in the room, and I shouldn’t bring them along. So, with that space, with Peach Tree and a couple of other not for profit organisations I've linked in with, there's a space created in that peer led consult where the kids are included in that, even if it is a clinical reason that you’re there, or a practitioner involvement.

VICKI MANSFIELD: Yeah. It’s so important, Amy, and it makes me think of some of the systemic issues that really are a point of advocating. Practitioners can be an advocate, for example, having a parent who made need to be hospitalised postpartum and negotiating with systems when there's not mother, baby beds available. Negotiating these systems around how we can support them to keep feeding or breastfeeding. So, I think there is a role for advocacy for practitioners to be one think and reflecting on what does this mean for this person in their role as a parent. What does this mean for this infant and how do we in some ways look at how systems can be more responsive and flexible to the needs of that period of life is so important, I think.

AMY PARKER: Peer-led is lived experience. I feel that the only way that we can break through those barriers with our practitioners, is if they really do set their mind and their head into what we are feeling within and how the situation that we’re in, to be able to support us. Put yourself in our shoes.

VICKI MANSFIELD: Thank you, Amy. I think that's a perfect spot to draw our conclusions before we do a little wrap up. Thank you so much, Amy and Viv, for sharing your insights and wisdom and knowledge today, and for giving us such great examples of a village approach, here particularly in Queensland, but also that can be in other areas as well. Just to finish up there will be a survey that will pop up. If you can complete that, that would be fantastic. Thank you to our audience for fitting us in at lunch time on a Wednesday. You can get the recording and the additional questions in the next few weeks.

Our next webinar is coming up in - let’s see. Is a CFCA webinar, and it’s from the Evidence and Evaluation Support Team. It’s on customer journey mapping and what it can tell us, on the 17th of April. There's also an AIFS conference coming up in June, and will showcase important research for the wellbeing of families across Australia. That registration’s still available, for early bird registration, the next couple of weeks. So, we’ll add to the AIFS list of topics, how to make systems flexible for the perinatal period. So, thank you so much to everybody for joining us today, and thank you for your engagement with the questions, and Amy and Viv, I'm incredibly grateful for you time with us today.

Welcome back to our Q&A recording for how to build a village around infants and toddlers, to support their mental health. One of the questions that we were going to look at for the Q&A, is what are some of the supports or additional barriers, for example, where there has been adversity, what supports might be needed for a family to be able to engage with a village? Viv, do you have a perspective? Because it’s not always an easy straight forward linear process.

VIV KASSANE: No, and people are very diverse and have a very diverse range of experiences as well. So, what we do at Peach Tree is that we really collaborate and build a collaborative relationship with parents to be able to meet them with where they are actually at, where they’re at, at that particular time. We try and minimise and reduce barriers as much as possible. We are fortunate to have funding, so it is a free service, so that financial barrier is removed. But also, we don’t have any time limitations on our service, so people can dip in and out of the services they need. We know that adversity doesn’t necessarily stop just because you've reached the end of your 10 sessions, or the services cease, and children continue to grow and develop and have needs.

So, at Peach Tree we don’t have any time limitation on you being able to attend our service. So, some mothers have been with is on their journey of multiple pregnancies and they come in and out of that service as they need and that they feel that they need that extra support at that time.

VICKI MANSFIELD: That really strikes me that each period of change in infants and toddlers and multiple pregnancy there's a whole range of different needs and having consistency and a holding environment is really conducive to infant mental health. Was there anything that you’d like to add, Amy?

AMY PARKER: Yeah, so Peach Tree specifically concentrates on the first five years, but it doesn’t end there. So, I've been with Peach Tree for six years, ongoing. I still have a few years to go. Hopefully, I do really well and don’t need their services anymore. I'm so blessed to have had everything that I've gotten from them and that safe space without barriers. Also, being able to help me engage with other services within the mental health network, to be able to help that support ongoing, because I feel like it’s a lifelong journey. That's one of the barriers that you get with mental health support services for yourself and your children is that it’s just a short-term band-aid, there's not that ongoing support that we need because we all have ups and downs.

With Peach Tree I will come in, on my good weeks I won’t engage with the services at all. I’ll socially connect with my Peachy Mummas and then when things are starting to feel a bit of challenge that's when I’ll reengage. I’ll got to yoga and have a coffee and have a chit-chat with others that are struggling. Maybe make myself feel better by instilling what I've learnt to other mums that are going through struggles that I've been through.

VICKI MANSFIELD: I think that's such an important reflection and comes back to where we started at the beginning or the webinar around having supports that are not siloed. That there’s a continuity of care and, Viv, you mentioned going from pregnancy through having that continuity from antenatal, if people are able to access such a powerful protective factor for infants, when parents are able to get supports antenatally as well. So, that may be another way of reducing some of those barriers is to get in even before bubs born sometimes.

AMY PARKER: I’d like to speak to that actually, sorry. I just want to interrupt. One of the biggest regrets I have in my journey is not engaging with Peach Tree services sooner. I was first introduced to them by a social worker at the hospital in the maternity outpatients with a leaflet with a picture of the logo, with the tree on the front. Everything was so overwhelming, they’re all new feelings and I didn’t know how I was going to engage with it, and in my head, I was like, this is another clinical service, I'm not really optimistic about where this is going with supporting me. I was so nervous, and it felt really intimidating having that. But I really wish I had engaged with them prior to the birth, because I had that first few weeks of my experience as a new mum, and completely isolated, completely alone, not knowing what to do, where to go, who to reach out to. Sorry, I’d just thought I’d share that.

VICKI MANSFIELD: Yeah, and that resonates with many mums that I've worked with antenatally and postnatally, is that if you can get supports antenatally and you can create relationship and safety then that's really powerful to be supportive throughout your post partem period as well.

VIV KASSANE: Ask for help. It’s hard to give yourself permission to admit that you need help. So, anyone who walks through our door, we work from the basis that this has been hard, well done. We’re so glad that you’re here. Also, referral processes as well, so if I can speak to that, we do take health professional referrals, but it’s not necessary. Parents can actually self-refer into our programs. Sometimes we might get those health professional referrals through as well and it might take us more than a few attempts to actually build the relationship with someone to the stage that they feel comfortable to walk through the door. So, we don’t have to put pressure on people to come here, we just – a gentle nudge reminders that hey, we’re here, we’d really love to see you.

VICKI MANSFIELD: So, allowing it to evolve rather than feeling like a pressure. Again, it’s that time and relationship sounds like it’s so important.

VIV KASSANE: We hear similar things to what Amy has expressed, all of the time and it’s about how reassured people feel when they actually realise that they’re not alone in these experiences.

VICKI MANSFIELD: Yeah, I don’t think we can ever underestimate and the importance of that in that early isolating period of being at home as you said, Amy. Thank you, Amy, and Viv, for sharing your insights again today and for offering us this additional time. Thanks for our audience for watching us and sharing the experience of the village approach today.

VIV KASSANE: Thank you.

AMY PARKER: Thank you so much.